Manual Therapy Techniques for Finger Stiffness
Presented by Ann Porretto-Loehrke
Nonfinancial: Ann Porretto-Loehrke is an instructor for the International Academy of Orthopedic Medicine—US.
Finger fractures and dislocations, often due to sports-related or occupational injuries, are common diagnoses seen in the hand therapy clinic. These injuries can result in stiffness, leading to significant functional impairment. This course will provide a guide to addressing these issues. The first portion of the course will cover the bony and soft-tissue anatomy of the digit, with an emphasis on joint arthrokinematics. For clinical testing, you’ll be provided with a systematic approach to identify your patient’s key impairments. The final portion of the course introduces manual therapy treatment techniques that can be used immediately in the clinic to maximize your patients' outcomes.
Meet your instructor
Ann Porretto-Loehrke
Ann Porretto-Loehrke is a skilled clinician with a passion for teaching and clinical treatment of upper extremity disorders. She has been practicing for 30 years and teaching continuing education courses for the past 20. She is the clinical development coordinator at the Hand to Shoulder Center in Appleton, Wisconsin. Ann is…
Chapters & learning objectives
1. Joint and Soft-Tissue Anatomy of the Finger
This chapter covers the bony and soft-tissue anatomy of the finger to set the stage for addressing key impairments seen following injury. The arthrokinematics of the digit will be presented, along with soft-tissue structures that can create limitations with finger motion, including the intrinsics, extrinsics, and oblique retinacular ligament (ORL).
2. Clinical Testing of the Finger
Through lecture and demonstration, this chapter covers the clinical testing of the finger to evaluate for stiffness at the joints, intrinsic muscles, and extrinsic muscles, and limitations with the superficial soft tissue. Special circumstances will also be discussed that can contribute to limitations with composite finger flexion, including the quadriga effect and the lumbrical plus phenomenon.
3. Manual Therapy Interventions
Through lecture and demonstration, this chapter covers specific joint mobilization techniques for the metacarpophalangeal (MP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints, addressing intrinsic and extrinsic tightness and manual soft-tissue methods to optimize finger motion.
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